摘要
目的分析肥胖和入院时高血糖对急性胰腺炎发生器官衰竭的预测作用。方法采用回顾性分析临床研究方法,收集2004年1月~2009年6月住院的急性胰腺炎资料,以39例重症急性胰腺炎伴器官衰竭病例为观察组,取同期56例无器官功能衰竭的急性重症胰腺炎病例为对照组。对两组病例的体重指数（BMI）、入院时血糖浓度、原患糖尿病数及观察组的器官衰竭数目进行统计学分析。结果观察组中单一器官衰竭31例,多器官衰竭8例。观察组的体重指数较对照组高[（26.687±1.658）kg/m2vs（25.746±1.157）kg/m2,P=0.0016]。观察组入院时血糖浓度较对照组高[（9.435±1.474）mmol/Lvs（8.089±1.244）mmol/L,P=0.000]。观察组入院前患糖尿病9例（23.08%）,对照组入院前患糖尿病3例（5.36%）,两组具有显著差异（P=0.0249）。观察组入院时血糖浓度与该组BMI具有相关性（r=0.797,P=0.000）,而对照组无此相关性（r=0.175,P=0.198）。回归分析表明观察组入院时血糖对重症急性胰腺炎发生器官衰竭数有明显影响（P=0.009）,而该组的BMI对器官衰竭数无影响（P=0.128）。结论入院时高血糖是急性胰腺炎发生器官衰竭的独立危险预测因素,肥胖本身并不是急性胰腺炎发生器衰竭的独立危险因素,但其可促进急性胰腺炎患者产生高血糖状态,进而可能发生器官衰竭。
Objective To investigate the predictable effect of obesity and admission hyperglycemia on acute pancreatitis（AP） with organ failure.Methods Data in study group of 39 severe AP patients with organ failure and control group of 56 severe AP patients without organ failure from January 2004 to June 2009 were retrospectively analyzed.Results There were 31 patients with single organ failure and 8 patients with multiple organ failure.Body mass index（BMI） was higher in study group than that in control group[（26.687±1.658）kg/m2 vs（25.746±1.157） kg/m2,P=0.0016].Admission serum glucose concentration was higher in study group that than in control group [（9.435±1.474） mmol/L vs（8.089±1.244）mmol/L,P=0.000].Glucose concentration was correlated with BMI in study group（r=0.797,P=0.000）,but not in control group（r=0.175,P=0.198）.Nine（23.08%） organ failure patients and 3（5.36%） controls had prior type 2 diabetes（P=0.0249）.The logistic regession analysis indicated that admission serum concentration was the only independent predictor of organ failure（P=0.009）.Conclusion Admission serum hyperglycemia may predispose to organ failure in AP.Obesity is not an indepentent risk factor for organ failure,but it may contribute to admission hyperglycemia in patients with AP.
出处
《胃肠病学和肝病学杂志》
CAS
2011年第2期187-189,共3页
Chinese Journal of Gastroenterology and Hepatology
